[monkeybrains21]

Is it possible to use insurance for T but sliding scale for say another mental health worker? I ask because my deductible is high and I have only been able to budget T for every other week, but she says I need meds but can't script. So I have to go somewhere else. I can't afford a lot due to paying 2/3 of my pay going to student loans( I am one if the few who does try to pay). My loans are suffocating. They are private so they never disappear and I can't get income based. They work with me some allowing me to pay interest only, but I don't make a lot of money.

The cost of everything is going up and there are no raises. I don't even get promoted when I am the best applicant since I'm not a straight white man.

[Perna]

Hi, monkeybrains, I am not sure what you are asking? You want to see 2 mental health workers? Sliding scale is totally up to the mental health worker, doesn't really have anything to do with insurance; insurance pays a certain amount and medical people accept that and/or maybe some are willing to not have you pay more/less, etc. Usually sliding scale is for those who are paying out-of-pocket, don't have/use insurance. But how much you pay is based on what you and your medical personnel decide on, some are more flexible than others, etc.

[monkeybrains21]

Originally Posted by Perna

Hi, monkeybrains, I am not sure what you are asking? You want to see 2 mental health workers? Sliding scale is totally up to the mental health worker, doesn't really have anything to do with insurance; insurance pays a certain amount and medical people accept that and/or maybe some are willing to not have you pay more/less, etc. Usually sliding scale is for those who are paying out-of-pocket, don't have/use insurance. But how much you pay is based on what you and your medical personnel decide on, some are more flexible than others, etc.

My T says she can't change what I pay because insurance sets it. The question I have is that if I have to see a Pdoc would I have to use my insurance? All docs are pretty new to me. I never go to docs.

[Perna]

The Pdoc would be the one to decide that. Most medical doctors (Pdoc) require insurance, don't have anything like "sliding fee". But insurance with a Pdoc works differently than insurance with your T because they are a medical doctor.

Insurance is almost always the cheaper route. It is harder in the first few months of the year because of high deductibles but that still comes out cheaper than if you had to pay $125-150 a session for PDoc if you did not have insurance. Probably the lowest he would go is, say $80/$90 and that's probably the same as the insurance rate you pay until your deductible kicks in.

Insurance IS a sliding fee scale; they get a "discount" because you are part of a group that has lots of people and if they did not accept that, all those people would go somewhere else so they would not get that money. People without insurance have to pay the regular rate and anything privately negotiated with the doctor/mental health person is probably going to be close to the insurance rate they get paid. Some therapists do have slots for one or two people they give sliding fees to who have no insurance and cannot afford to pay, etc. but that is an individual decision by the health care worker, usually a T, not a doctor/Pdoc.

A lot more pdoc's aren't taking insurance. Then it is out of network. That could work if you find a clinic who will work on a sliding scale. Depending on the laws in your state you could see a physician assistant who is more like a nurse who prescribes. They tend to be cheaper. I don't know your situation obviously but have you done research on other options that don't require meds?

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[monkeybrains21]

Yes I have. I've tried herbal supplements, tried meditation just can't be still, I've tried many different forms of exercise. The only things I found that truely calm me is pot but it's not legal where I am and I started to have really bad paranoia when I smoked after my sister died. And then I used to be a cutter, that was very calming but I haven't don't that since right before my sister died.

It sounds like you have done due diligence. Sorry you are feeling so bad. I have found any physical, art or meditation practice that promotes mindfulness is the most helpful because you can turn to it anywhere. That an a good whole food, traditional diet. The standard American diet (SAD) is particularly high in carbs which definitely affect your mood along with sugar. Definitely more challenging but better in the long run.

My other advice would be when you are speaking to the person prescribing keep asking is that available in generic. There are so many meds available in generic form that I don't see an advantage for going to a branded med. If you end up in a place without insurance you could seriously be looking at hundreds of dollars a month. Be careful of samples and coupons. Samples run out and you may be paying a lot. Most coupon require insurance so if you don't have it you are also SOL only now you are dependent on the drug. Some generics are as little as 10 dollars.

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[monkeybrains21]

Michanne

I actually watch very carefully what I eat. I don't usually eat many carbs. I'm very active at work and home. I'm extremely weird in the fact that even when really depressed I can separate myself from well myself. I make myself go to work everyday. I make myself clean everything at home. Laundry dishes just cleaning the entire house.

Ok

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[justbeingme80]

That would be up to the doctor. I would, however, check with your insurance as psychiatrists are covered as medical doctors and it might be different benefits than your 60 copay for your therapist. Depending on your income, you might be able to go to a clinic as well.